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General NPI Number Information
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NPI Number | 1912503293
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Entity Type | Organization
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Legal Business Name | GRATUS COMPREHENSIVE HOME SERVICES LLC
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 29425 NORTHWESTERN HWY STE 202
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1015
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Country | US
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Telephone | 313-952-6790
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Fax |
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Provider Business Mailing Address
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Address Line | 32501 W 13 MILE RD
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2011
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Country | US
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Telephone | 313-952-6790
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS ANGELA TASHA WILLIAMS
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Credential | FNP
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Telephone | 313-952-6790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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